Supervision Blog

You can browse my website pages:

• About Canh (Education, Training, Who I Work With)

• Therapeutic Approach

• Services (What I Offer)

You can view my LinkedIn profile.

I enjoy working with older associate clinicians, career changers, and those who have a bit of life experience.

I enjoy working with associates who prefer a direct, casual, and no nonsense approach to supervision.

I enjoy working with associates who are okay with taking risks, trying new ways of practicing therapy, and making mistakes and subsequently learning how to repair ruptures/conflicts/disagreements.

I enjoy working with supervisees who have another primary supervisor and want to supplement supervision with me through learning a specific modality, focus on an area of speciality like trauma or relationships, etc.

Good Fit For Those Who Prefer A Supervisor Who:

• Is direct, engaged, authentic, and relational

• Emphasizes the relational aspects of supervision

• Spends time exploring my personal feelings and responses to my work

• Emphasizes the importance of self-awareness, personal thoughts, and personal feelings in my development

• Has extensive personal experience as a practitioner and shares from that experience (successes and failures)

• Encourages my independent functioning and decision-making ability

• Challenges me to integrate ideas and information from a number of different sources

• Evaluates my success based on mutually determined goals and objectives

Poor Fit For Those Who Prefer A Supervisor Who:

• Is more objective, more neutral, and passive in session

• Gives detailed instructions as to how the work should be done

• Makes most of the decisions

• Expects me to learn by watching how they do the work

• Emphasizes the task aspect of the work

• Gives very specific instructions and feedback for any changes

• Closely monitors my work

• Micro manages

• Strictly and rigidly follows rules and procedures

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Washington State Department of Health - Provider Search (Verify License)

Educator & Teacher

• Aids in development of counseling knowledge and skills by identifying learning needs, determining counselor strengths, promoting self-awareness, and transmitting knowledge for practical use and professional growth.

• Supervisors are teachers, trainers, and professional role models.

Consultant

• Provides case consultation and review, monitoring performance, counseling the counselor regarding job performance, and assessing counselors.

Support & Coach

• In this supportive role, supervisors provide morale building, assess strengths and needs, suggest varying clinical approaches, model, cheer-lead, and prevent burnout.

• For entry-level counselors, the supportive function is critical.

Mentor

• The experienced supervisor mentors and teaches the supervisee through role modeling, facilitates the counselor's overall professional development and sense of professional identity, and trains the next generation of supervisors.

Effective supervision depends on a variety of factors including:

• A good fit between supervisor and supervisee (personality, temperament, values, communication styles, etc.).

• Consider what your preferences are in a supervisor and what makes you feel comfortable (age, ethnicity, race, gender, sexuality, ability, etc.) as this can be a good starting point.

• Discussing boundaries, expectations, and ground rules in the beginning and ongoing to avoid miscommunication, misunderstandings, and unmet needs/wants.

• A strong collaborative supervision relationship based on sharing power, shared values, making meaning, empathy, direct communication, and more.

• Balance between support and challenge, validation and constructive feedback, etc.

For Supervisors

• An active listener

• Open and curious

• Open to feedback and toward growth

• Has a beginner’s mind and is open to learning and growing vs. thinking they already know everything

• Provides direct, helpful, and specific feedback

• Adaptable and flexible

• Understands how power, privilege, and difference shapes the supervision relationship and dynamics and brings this up

• Honest when they are unable to help the supervisee and offers resources or connections to other contacts/people

• Repairing ruptures and disagreements as they arise

• Regularly attends training and education on providing effective supervision

• Understands the role of a supervisor

• Adheres to their profession’s code of ethics

• Offers a consistent schedule for supervision meetings and offers backup when they cancel, are ill, and/or on vacation

For Supervisees

• Ready to discuss topics

• Open and curious

• Open to feedback and toward growth

• Has a beginner’s mind and is open to learning and growing vs. thinking they already know everything

• Provides direct feedback

• Asks for what they need

• Does the work outside of supervision

• Is honest with themselves through self-reflection and self-understanding

• Practices self compassion

• Understands the role of a supervisee

• Adheres to their profession’s code of ethics

• Attends supervision as agreed upon and notifies when they will be absent due to illness or vacation

• To protect clients from harm and ineffective therapy

• To provide a third ear or outside perspective on client cases

• To help therapists do their best work with clients through refinement of skills, orientation, and interventions

• To help therapists with the basics of psychotherapy (ethics, documentation, diagnosis, risk assessment, ending/termination/discharge, skills and interventions, treatment planning, etc.)

• To help therapists become more competent and confident as they become independently licensed

Definitions

• “Supervision is a disciplined, tutorial process wherein principles are transformed into practical skills, with four overlapping foci: administrative, evaluative, clinical, and supportive” (Powell & Brodsky, 2004, p. 11).

• “Supervision is an intervention provided by a senior member of a profession to a more junior member or members. … This relationship is evaluative, extends over time, and has the simultaneous purposes of enhancing the professional functioning of the more junior person(s); monitoring the quality of professional services offered to the clients that she, he, or they see; and serving as a gatekeeper of those who are to enter the particular profession” (Bernard & Goodyear, 2004, p. 8).

• Supervision is “a social influence process that occurs over time, in which the supervisor participates with supervisees to ensure quality of clinical care. Effective supervisors observe, mentor, coach, evaluate, inspire, and create an atmosphere that promotes self-motivation, learning, and professional development. They build teams, create cohesion, resolve conflict, and shape agency culture, while attending to ethical and diversity issues in all aspects of the process. Such supervision is key to both quality improvement and the successful implementation of consensus- and evidence-based practices” (CSAT, 2007, p. 3).

There are several domains of supervision. This includes:

Administrative

Focuses on organizational accountability such as: case records, referrals, performance reviews, other tasks that do not directly relate to client services.

Clinical

Focuses on supporting the supervises professional development, clinical skills, and client services, including: the therapeutic relationship. assessment and interventions, client welfare.

Ethical and Legal

Focuses on ethical dilemmas, boundary issues, and ensuring the well-being of clients and supervisees, promoting responsible and trustworthy practice.

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You might talk about:

• Legal issues and liability

• Countertransference issues (feelings you have about your clients)

• Documentation and note taking

• Clinical skills and interventions

• Theoretical orientations and frameworks for change

• Measuring outcome and asking for feedback (evaluation)

• Fees and finances

• Endings and terminations

• Receiving support and guidance

• Receiving education about possible professional trainings, development, and seminars

• Receiving education on possible career routes as a clinical social worker or therapist

• Receiving education on marketing and advertising if you are in private or group practice

• Becoming more confident as a therapist

• Managing impostor syndrome

• Self care

• Managing compassion fatigue and secondary trauma

• Noticing signs toward burn out

• How to bounce back from burn out

• And more

Sample Topics You Might Discuss In Supervision

Client Caseload Management

• Protection and monitoring of client welfare

• Reviewing clients (treatment, goals, risks, etc.)

• Assessing to see how your caseload feels (e.g. reducing or increasing client hours)

Taking Time Off

• How to take time off, when to notify clients, and how to notify clients

• Unexpected time off due to illness, accident, or unforeseen circumstances

• Backup coverage for clients when you are on extended leave

Marketing & Advertising

• If you are working for a group practice or operate your own private practice, you may be unsure how to run a small business

• School taught us the basics of clinical skills and therapy, but did not teach us the business aspects of running a small business

• Your supervisor can help you find authentic and congruent ways for you to market and advertise to your ideal client and areas of niche(s)

Strengthening Clinical Skills

• Perhaps you want to specialize in a therapeutic approach such as CBT, CPT, PE, EMDR, IFS, SE, etc.

• Your supervisor may have advanced clinical training and consultation in such approaches and can help you learn and refine your clinical skills with clients

• Deliberate practice is a great way to strengthen your clinical skills through the use of practical and applicable clinical exercises and practices

• Reviewing videos and audio clips are another way to strengthen clinical skills

• Lastly, writing up a process recording is another way to strengthen your clinical skills

Specialities & Areas of Focus

• How and if you want to develop an area of focus (generalist vs. specialist)

• The benefits and limits to certifications post-grad

• Lifelong learning and continuing education

• Professional development opportunities

Ethics

• Dual relationships

• Boundary crossings and boundary violations

• Informed consent

• Confidentiality and its limits

• Client welfare and “do no harm” principle

• Therapist violations and unprofessional conduct

Self Care

• How do we hold a wide range of human experiences like suffering, pain, hurt, joy, and love without personalizing and taking on the client’s “stuff”?

• How do we continue to do this work in a sustainable, long-term way honoring our boundaries and limits?

• Understanding the reality of compassion fatigue and ways toward personal joy, liberation, and resilience.

Defenses & Anxiety

• How do we work with resistance and psychological defenses and avoiding crashing into them?

• The difference between defense and anxiety

• Ways to bypass defenses

• Ways to regulate anxiety

• Building client capacity to reflect, tolerate, and relate to their emotions and thoughts in a manageable way

Trauma

• How do we avoid re-traumatizing clients with a history of complex and developmental trauma?

• How do we avoid re-traumatizing ourselves as a therapist with a history of trauma?

Culturally Attuned Care

• How do we build and increase our awareness, knowledge, understanding, and skills working with different dimensions of difference?

• How do we manage our own cultural countertransference so it doesn’t interfere with our client’s cultural “stuff”?

• How do we continually practice culturally responsibility and reflective practice so we can open up difficult conversations around trauma, oppression, micro/macroaggressions, and difference?

Congruence

• How do we learn to listen to our authentic selves/intuiton in addition to using evidenced based practices?

• How do we develop our own therapeutic style unique to our identities and experiences?

Boundaries

• What is the therapeutic frame and how can we hold strong therapeutic boundaries in service of both our clients and ourselves?

• How do we flexibly use the therapeutic frame toward healing for our clients?

Therapeutic Relationship

• How do we repair ruptures, conflicts, and misalliances?

• How do we ensure that we are building consistent therapeutic progress?

• How do we become more comfortable with endings and saying goodbye (termination)?

• Conversations and explorations around transference and countertransference

Pacing

• How do we become more comfortable with imperfection, tension, patience, uncertainty, and not knowing?

• How do we incorporate collaborative client-centered care into our practice?

Suicidality

• Suicide assessments

• Safety plans

• Assessing for self harm

• Assessing for non-suicidal self injurious behaviors

• Limits to confidentiality

Endings & Terminations

• How to say goodbye to clients

• Reviewing and summarizing treatment

• Anticipating future client obstacles and challenges

• Letting the client matter to you

• Gifts and rituals

Referrals

• When to refer out for a higher level of care than outpatient care (IOP, PHP, IP)

• When to refer out due to client need for specialized therapy training and skill

• How to start the conversation around referring out

If you want to learn how to open your private practice in Washington State, I recommend the following resource here which outlines step-by-step instructions at no cost.

Click here for a list of free supervision resources.

Click here for referrals to other supervisors.